HEALTH AND SAFETY

SENATE FILE 3 - Termination of Pregnancy Reports - Induced Termination Methods
HOUSE FILE 389 - Controlled and Precursor Substances - Miscellaneous Changes
HOUSE FILE 396 - Disaster Preparedness
HOUSE FILE 454 - Newborn and Infant Hearing Screening
HOUSE FILE 479 - Medical Assistance Program Managed Care or Prepaid Services Contracts - Approved Health Care Services Providers - Advanced Registered Nurse Practitioners
HOUSE FILE 503 - Podiatrists - Administration of Anesthesia
HOUSE FILE 541 - Birth Certificates - Fees
HOUSE FILE 557 - Volunteer Health Care Provider Program Participants - Liability
HOUSE FILE 565 - Healthy and Well Kids in Iowa Program
HOUSE FILE 619 - Regulation of Health Care - Pharmaceuticals - Medical Assistance Program
HOUSE FILE 628 - Regulation of Physician Assistant Services
HOUSE FILE 641 - Public Health Regulation - Miscellaneous Provisions

RELATED LEGISLATION

SENATE FILE 36 - Miscellaneous Supplemental and Other Appropriations

SEE APPROPRIATIONS. This Act makes supplemental appropriations for FY 2002-2003 and includes an appropriation to the Department of Public Safety for the State Fire Marshal.

SENATE FILE 127 - Breast Cancer Awareness Motor Vehicle License Plates - Fees - Appropriation

SEE TRANSPORTATION. This Act creates a special breast cancer awareness motor vehicle registration plate to raise funds for certain nonprofit organizations to provide free mammograms to qualified individuals.

SENATE FILE 155 - Substantive Code Corrections

SEE STATE GOVERNMENT. This Act contains statutory corrections that include changes related to clandestine laboratory sites, the Division of Criminal Investigation of the Department of Public Safety, Department of Public Health administrative duties, regulation of farmers markets, regulation of registered dental assistants, grade "A" milk inspection, possession of anthrax, the confinement of sexually violent predators, child abuse reporting and investigations, domestic abuse, licensing and regulation of child care facilities, emergency services funds, animal feeding operations, operation of personal watercraft, the killing of animals, and the Interstate Compact for Adult Offender Supervision.

SENATE FILE 237 - Water Quality Protection Fund - Private Water Supply Systems - Deposit and Use of Permit Fees

SEE ENVIRONMENTAL PROTECTION. This Act allows the Department of Natural Resources to collect permit fees from private water supply well contractors and appropriates the moneys collected to be used for the purpose of supporting programs established to protect private drinking water supplies.

SENATE FILE 357 - City Hospital or Health Care Facility Trustees - Residency - Vacancies

SEE ELECTIONS, ETHICS & CAMPAIGN FINANCE. This Act makes changes relating to election of the board of trustees of a city hospital or city health care facility.

SENATE FILE 361 - Civil Commitment - Emergency Procedures

SEE CIVIL LAW, PROCEDURE & COURT ADMINISTRATION. This Act relates to emergency procedures for the temporary detention and treatment of persons who are incapacitated or impaired due to substance abuse or mental health problems.

SENATE FILE 401 - Regulation of Tobacco Retailers

SEE BUSINESS, BANKING & INSURANCE. This Act relates to regulation of tobacco products and cigarette retailers. The Act provides for the transfer of certain violations by tobacco product and cigarette manufacturers from a county health department, city health department, or city to the Iowa Department of Public Health. This provision applies to violations pending on April 11, 2003, for which a penalty has not been assessed.

SENATE FILE 453 - State and Local Government Financial and Regulatory Matters - Miscellaneous Provisions

SEE APPROPRIATIONS. This Act addresses state and local government financial and regulatory matters. Legislators referred to this legislation as the "Government Reinvention Bill" during debate and discussion. The Act includes provisions revising Medicaid Program requirements.

SENATE FILE 458 - Miscellaneous Appropriations, Reductions, Revenue Adjustments, and Other Matters

SEE APPROPRIATIONS. Division IV of this Act reduces by $20 million the amount to be appropriated to the Endowment for Iowa's Health Account. Division VII requires the Department of Public Defense, beginning July 1, 2004, to approve and support the development and ongoing operations of an urban search and rescue team, requires the Department of Public Defense to develop and implement a uniform incident command system, requires public safety workers and other appropriate individuals to receive smallpox vaccinations, and includes other provisions related to the providing of such vaccinations.

S.J.R. 5 - Nullification of Administrative Rule - Ammonia and Hydrogen Sulfide Ambient Air Standards

SEE ENVIRONMENTAL PROTECTION. This Joint Resolution nullifies the amendments to an administrative rule and nullifies a new administrative rule adopted by the Environmental Protection Commission of the Department of Natural Resources on April 21, 2003, to prevent the adoption of certain new ambient air quality standards that regulate ammonia and hydrogen sulfide levels in the air. The Joint Resolution takes effect April 30, 2003.

HOUSE FILE 66 - Motor Vehicle Traffic Regulation - Stationary Utility or Municipal Maintenance Vehicles

SEE TRANSPORTATION. This Act prescribes certain safety precautions the driver of a motor vehicle is required to take when approaching a stationary utility maintenance vehicle or a stationary municipal maintenance vehicle displaying flashing yellow, amber or red lights. Violators are subject to a scheduled fine of $50.

HOUSE FILE 204 - Massage Therapy - Modalities - Licensing Exemption

SEE STATE GOVERNMENT. This Act provides for a study regarding massage therapy modalities and provides for a temporary exemption from licensure for individuals exclusively engaged in the practice of reflexology or an unlicensed individual whose professional practice does not fall within the current definition of "massage therapy."

HOUSE FILE 216 - Dissemination of Intelligence Data and Intelligence Assessments

SEE CRIMINAL LAW, PROCEDURE & CORRECTIONS. This Act provides that intelligence data in the files of the Department of Public Safety may be disseminated to an agency, organization or person in order to protect a person or property from a threat of imminent harm. The Act takes effect April 9, 2003.

HOUSE FILE 381 - Anatomical Gifts - State Employee Leaves - Grants

SEE LABOR & EMPLOYMENT. This Act establishes a bone marrow and vascular organ donation incentive program for state employees. The Act also provides for a different use of moneys in the Anatomical Gift Public Awareness and Transplantation Fund.

HOUSE FILE 386 - Policy and Services for the Elderly

SEE HUMAN SERVICES. This Act relates to the Department of Elder Affairs (DEA) and the Elder Iowans Act. The Act specifies that the Long-Term Care Resident's Advocate is to advocate for residents of long-term care facilities excluding those facilities licensed primarily to serve persons with mental retardation or mental illness. The Act eliminates the directive to DEA to develop and disseminate information regarding Medicare supplemental insurance policies as this function is performed by the Insurance Division of the Department of Commerce.

HOUSE FILE 387 - Mental Health and Developmental Disabilities - Facilities - Programs - Commission

SEE HUMAN SERVICES. This Act relates to mental health and developmental disabilities services by revising requirements for intermediate care facilities for persons with mental retardation, expanding an exemption to health care licensing requirements for certain residential programs that receive funding under a medical assistance (Medicaid) home and community-based services waiver and that receive approval from the Department of Human Services, and revising membership provisions for the Mental Health and Developmental Disabilities Commission.

HOUSE FILE 455 - Burn Injury Reports by Treatment Providers

SEE CRIMINAL LAW, PROCEDURE & CORRECTIONS. This Act requires licensed health-related professionals to report certain burn injuries to a law enforcement agency.

HOUSE FILE 472 - Federal Block Grant Appropriations

SEE APPROPRIATIONS. This Act appropriates federal block grant and other nonstate moneys to state agencies for the federal fiscal year beginning October 1, 2003, and ending September 30, 2004. The Act includes funding for maternal and child health, preventive health and health services, substance abuse programs, low-income energy assistance, mental health, child care, social services, and other health and human services-related programs.

HOUSE FILE 543 - Insurance - Mammography Exam Coverage

SEE BUSINESS, BANKING & INSURANCE. This Act provides that, in addition to the minimum mammography examination currently required by statute for women age 35 and above, coverage for more frequent mammograms is also required if recommended by a woman's physician.

HOUSE FILE 549 - Education - Administration, Regulation, and Other Related Matters

SEE EDUCATION. This Act relates to the duties and operations of the Department of Education, school districts, area education agencies, and the State Board of Regents. The Act also permits an insulin-dependent diabetic to qualify as a school bus driver if the person is verified physically able to perform the required functions despite insulin dependency, the school district or school employing the insulin-dependent diabetic bus driver monitors the bus driver, and the driver is in compliance with requirements specified by the Act.

HOUSE FILE 558 - Disclosure of Information to Subjects of Child or Dependent Adult Abuse Reports

SEE HUMAN SERVICES. This Act authorizes the Department of Human Services to disclose information to certain persons regarding the listing of an individual in the Child or Dependent Adult Abuse Registry or the Sex Offender Registry when the disclosure is necessary for the protection of a child or dependent adult.

HOUSE FILE 584 - Recreational Activities in Designated Areas or on Public Property - Liability Limited

SEE CIVIL LAW, PROCEDURE & COURT ADMINISTRATION. This Act provides certain exceptions to liability for prior owners of land in which an all-terrain vehicle recreational riding area is established, and for a municipality and officers and employees of a municipality involving a public facility designed for the purpose of bicycling, unicycling, scootering, river rafting, canoeing, or kayaking.

HOUSE FILE 667 - Appropriations - Health and Human Services

SEE HUMAN SERVICES. This Act appropriates funds from the General Fund of the State to the Iowa Department of Public Health for programs and services relating to addictive disorders, adult wellness, child and adolescent wellness, chronic conditions, community capacity, elderly wellness, environmental hazards, infectious diseases, injuries, and public protection. The Act appropriates funds from the Gambling Treatment Fund for addictive disorders, including gambling. The Act extends the Vital Records Modernization Project until June 30, 2004, and the Scope of Practice Review Committee project until July 1, 2004. The Act also directs the Director of Public Health to establish a Health Care Access Partnership Pilot Project.

HOUSE FILE 672 - Adult Day Services

SEE HUMAN SERVICES. This Act establishes regulatory provisions for adult day services.

HOUSE FILE 675 - Regulation of Elder Family Homes, Elder Group Homes, and Assisted Living Programs - Fire and Safety Standards

SEE HUMAN SERVICES. This Act provides for regulation of elder group homes and assisted living programs and eliminates the Code chapter relating to elder family homes.

HOUSE FILE 676 - Veterans Trust Fund

SEE STATE GOVERNMENT. This Act establishes a Veterans Trust Fund under the control of the Commission of Veterans Affairs to be used for the benefit of military veterans, their spouses, and dependents for health care and other expenses.

HOUSE FILE 685 - Healthy Iowans Tobacco Trust and Tobacco Settlement Trust Fund - Appropriations

SEE APPROPRIATIONS. This Act relates to and makes appropriations from the Healthy Iowans Tobacco Trust. The Act appropriates funds to the Iowa Department of Public Health (IDPH) for the Tobacco Use Prevention and Control Program, for a program that utilizes high school mentors in an effort to reduce the illegal use of substances, for provision of smoking cessation products, and for additional substance abuse treatment. The Act also appropriates funds to IDPH for development of a Healthy Iowans 2010 Plan.

HEALTH AND SAFETY

SENATE FILE 3 - Termination of Pregnancy Reports - Induced Termination Methods (full text of bill)
BY JOHNSON. This Act requires a health care provider making a termination of pregnancy report to the Iowa Department of Public Health to provide information regarding the method used for an induced termination, including whether mifepristone (RU-486) was used.

HOUSE FILE 389 - Controlled and Precursor Substances - Miscellaneous Changes (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act provides for several technical changes to Code chapters regarding controlled substances and precursor substances to reflect recent amendments to the federal Uniform Controlled Substances Act and relating to precursor chemicals. The Act also provides for the suspension, revocation or restriction of a registrant's authority to handle or prescribe controlled substances if the registrant is a licensed health care professional and has been the subject of disciplinary action by the applicable health professional licensing board.

HOUSE FILE 396 - Disaster Preparedness (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act establishes a new Code Division XV, entitled "Disaster Preparedness" within Code Chapter 135, the Iowa Department of Public Health (IDPH) chapter, and establishes public health measures and procedures to be followed if a public health disaster is declared.

The Act establishes the Division of Epidemiology, Emergency Medical Services, and Disaster Operations within IDPH. The Act establishes duties for the department; establishes provisions related to health care supplies when a public health disaster exists or is imminent; authorizes the department to establish disaster medical assistance teams to supplement medical and public health resources during times of disaster; authorizes the department to receive, distribute and administer items of the federal Strategic National Stockpile Program; directs the department to carry out additional duties during a public health disaster; and provides for information sharing related to a public health disaster. The Act also authorizes IDPH to investigate and control diseases, illnesses, and health conditions that may be a potential cause of a public health disaster.

The Act takes effect April 14, 2003.

HOUSE FILE 454 - Newborn and Infant Hearing Screening (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act requires universal newborn and infant hearing screening. The Act requires that beginning January 1, 2004, all infants born in the state are to be screened for hearing loss using one of the prescribed methods. The Act specifies the duties of birthing hospitals, birth centers, and other health care professionals in complying with the Act, including reporting of the results of the screening to the parent or guardian of the newborn or infant and to the Iowa Department of Public Health (IDPH). The Act provides for the sharing of information reported to IDPH and requires area education agencies with whom information is shared to report certain information to IDPH relating to a newborn's or infant's hearing, follow-up, and intervention services. The Act provides an exception if the parent objects to the screening. The Act provides immunity from liability for a person acting in good faith in complying with the Act.

HOUSE FILE 479 - Medical Assistance Program Managed Care or Prepaid Services Contracts - Approved Health Care Services Providers - Advanced Registered Nurse Practitioners (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act provides that licensed advanced registered nurse practitioners will be regarded as approved providers of health care services, including primary care, for purposes of managed care or prepaid services contracts under the Medical Assistance (Medicaid) Program. The Act also provides that the scope of practice of an advanced registered nurse practitioner is not intended to be expanded based upon the Act's provisions.

HOUSE FILE 503 - Podiatrists - Administration of Anesthesia (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act relates to the administration of anesthesia by a podiatrist. The Code currently provides that a podiatrist is not authorized to utilize any anesthetics other than local anesthetics. The Act is intended to clarify what is meant by "local anesthetics," providing that a licensed podiatric physician can administer local anesthesia, and that this local anesthesia, or conscious sedation, can be administered in a hospital or an ambulatory surgical center.

HOUSE FILE 541 - Birth Certificates - Fees (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act increases the fee for the registration of a birth certificate to $15 beginning July 1, 2003, and ending June 30, 2005, and to $20 beginning July 1, 2005, in order to provide funding for both child abuse prevention and the Birth Defects Institute Central Registry.

Current Code requires a fee for registration of a birth certificate of $10 and the funds generated from collection of the fees are designated for primary and secondary child abuse prevention programs. Under the Act, during the period from July 1, 2003, until June 30, 2005, of the $15 fee, $10 would still be used to fund primary and secondary child abuse prevention programs and the increase of $5 would be used to fund the Birth Defects Institute Central Registry. Under the Act, beginning July 1, 2005, of the $20 fee, $10 would still be used to fund primary and secondary child abuse prevention programs and the increase of $10 would be used to fund the Birth Defects Institute Central Registry.

HOUSE FILE 557 - Volunteer Health Care Provider Program Participants - Liability (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act adds free clinics to the listing of eligible health care facilities and adds psychologists, social workers, mental health counselors, and pharmacists to the listing of participating health care providers under the Volunteer Health Care Provider Program established within the Iowa Department of Public Health.

HOUSE FILE 565 - Healthy and Well Kids in Iowa Program (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act relates to the Healthy and Well Kids in Iowa (hawk i) Program and the Medical Assistance (Medicaid) Program.

The Act deletes the requirement that the Department of Human Services (DHS) establish family cost sharing based on a sliding fee scale. The new language reflects current practice, which is establishment of a cost-sharing amount of not less than $10 per individual and $20 per family with the approval of the hawk i Board. The Act also directs DHS to perform annual, random reviews of enrollee applications to ensure program compliance. Quality assurance reports are to be made to the board and to DHS based upon the data maintained by the administrative contractor of the program. The Act changes the minimum number of required meetings of the hawk i Board from not less than 10 times annually to not less than six but not more than 12 times annually.

The Act eliminates the requirement that the outreach efforts developed by the board include a comprehensive statewide media campaign. The Act directs the board, in consultation with the Clinical Advisory Committee, to assess the initial health status of children participating in the program, establish a baseline, and develop appropriate indicators to assess the subsequent health status of children participating in the program, rather than directing the board to select a single, nationally recognized assessment form for children participating in the program. The Act eliminates the requirement that the board perform periodic random reviews of enrollee applications to assure program compliance, as this function is given to the department under the Act. The Act also directs the advisory committee on children with special health care needs to make recommendations, annually, by January 1, rather than only one time by January 1, 1999.

The Act eliminates the directive to the hawk i Board to adopt rules to address approval of a program application in cases in which prior employer sponsored coverage ended less than six months prior to determination of eligibility for the program. The Act also eliminates a requirement that participating insurers submit a marketing plan to the hawk i Board consistent with the board's outreach plan, for approval by the board.

The Act amends the directive to the administrative contractor to forward names of children who appear to be eligible for health insurance coverage, other than Medicaid, to local offices of DHS or other appropriate persons, and limits the directive to forwarding the names of children who appear to be eligible for Medicaid only to the state offices of DHS. The Act also eliminates the directive to the administrative contractor to make program applications available through the mail and through local sites, as determined by DHS, including to schools, local health departments, local DHS offices, and other locations.

The Act also provides that a child may participate in the hawk i Program if, among other criteria, the child is not currently covered under a group health plan unless allowed by rule of the board.

The Act also allows for cost sharing based upon the family income percentage that is either below 150 percent of the federal poverty level or which equals or exceeds 150 percent of the federal poverty level.

The Act directs DHS to monitor the effects of eliminating the directive to the hawk-i Board relating to prior employer-sponsored coverage. The department is to continue the monitoring until June 30, 2005, and is to file an annual report that includes reporting of any increased program cost resulting from the elimination of the directive.

HOUSE FILE 619 - Regulation of Health Care - Pharmaceuticals - Medical Assistance Program (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act relates to health care services and programs including health care services provided under the Medical Assistance (Medicaid) Program.

The Act establishes an Interagency Pharmaceuticals Bulk Purchasing Council within the Iowa Department of Public Health to provide for bulk purchasing of pharmaceuticals across state agencies by a selected central purchasing agency. The Act also authorizes the council to conduct such purchasing with local governments. The Act specifies that the Department of Pharmaceutical Care of the University of Iowa Hospitals and Clinics is to act in an advisory capacity to the council.

The Act provides for assessment of residents of health care facilities to determine their eligibility for veterans' benefits through the federal Department of Veterans Affairs.

The Act directs the Department of Human Services (DHS) to establish and implement a Preferred Drug List Program under the Medicaid Program. The Act provides for the establishment of a pharmaceutical and therapeutics committee to recommend and periodically review a preferred drug list. The Act requires that any drug not included in the preferred drug list is subject to prior authorization, with specified exceptions. The Act provides that DHS may negotiate supplemental rebates with pharmaceutical manufacturers, provides that the initial preferred drug list is to be a list developed by a midwestern state and approved by the federal government, and provides that DHS may procure a sole source contract to participate in a pharmaceutical pooling program for Medicaid recipients. This provision takes effect May 2, 2003.

The Act provides for a quality assurance assessment on nursing facilities, with moneys generated to be deposited in the Senior Living Trust Fund. This provision does not take effect until DHS receives federal approval of a state plan amendment to the Medicaid state plan and approval of an application for a waiver of the uniform tax requirement. However, the directive to DHS to request a state plan amendment and approval of a waiver of the uniform tax requirement takes effect May 2, 2003.

The Act provides that a level of care determination for an individual seeking approval to receive services under a Medicaid Program home and community-based services waiver is to be conducted only by a person not participating as a provider of services under the waiver. The Act also provides that funds appropriated to the Department of Elder Affairs (DEA) to conduct the level of care determinations are to be transferred to DHS, and authorizes DHS to enter a sole source contract to conduct the determinations.

The Act replaces the current authorization with a requirement that DHS issue a notice establishing and demanding payment of an accrued or accruing spousal support debt due and owing the department.

The Act directs DHS under the Medicaid Program to reimburse pharmacy dispensing fees at a single rate of $4.26 per prescription or the pharmacy's usual and customary fee, whichever is lower; require a copayment of recipients for each prescription filled; establish an ingredient reimbursement basis equal to the average wholesale price minus 12 percent; continue the sole source contract for the State Maximum Allowable Cost (SMAC) Program and expand the program to the greatest extent possible; establish the SMAC reimbursement rate at the average wholesale acquisition cost adjusted by a multiplier of 1.4; require Medicaid recipients to pay a copayment of $3 per physician office visit; maximize expansion of prior authorization of prescription drugs; and establish a fixed-fee reimbursement schedule for home health agencies. The provisions relating to the SMAC Program take effect May 2, 2003.

The Act provides that it is the intent of the General Assembly that the consolidation of home and community-based services waivers be designed so as not to result in additional cost, with the exception of any services added to the waivers by the General Assembly. The Act directs DHS to submit an initial report regarding the cost neutrality and status of the waiver consolidation to the Legislative Fiscal Committee by January 1, 2004, and a subsequent report by July 31, 2004.

The Act provides that if Medicaid nursing facility reimbursement exceeds the amount appropriated for that purpose, DHS is to adjust the inflation factor of the rate calculation to provide reimbursement within the amount projected.

The Act directs DHS to conduct an ongoing review of recipients and providers of Medicaid services to determine the appropriateness of usage and to conduct a review of selected services categories and providers over three fiscal years to determine program compliance.

The Act provides for the implementation of a supplemental payment adjustment to physician services reimbursed under Medicaid at publicly owned acute care teaching hospitals. The payments collected from hospitals are to be deposited in the DHS Medical Assistance Account. This provision takes effect May 2, 2003.

The Act directs DHS to aggressively pursue chronic disease management and provides for the conducting of a pilot project for a select number of individuals who are participants in the Medicaid Program. The Act requires DHS to submit a progress report regarding chronic disease management measures undertaken under the Act by November 1, 2003. This provision takes effect May 2, 2003.

See S.F. 458 (Appropriations) for amendments to H.F. 619. Senate File 458 made the following changes to H.F. 619:

• Amends the provision related to assessment of residents in health care facilities so that instead of determining the eligibility of residents for veterans' benefits, eligibility of residents is merely identified.
• Amends the provision relating to the preferred drug list under Medicaid to provide a procedure for disclosure of information relating to prices manufacturers or wholesalers charge for pharmaceuticals.
• Amends the provision relating to the nursing facility quality assurance assessment to provide for a reimbursement to nursing facilities calculated as a per patient day amount.
• Amends the provision relating to home and community-based services waiver eligibility determinations by striking the section and providing instead that DEA, in collaboration with DHS, area agencies on aging, advocacy groups, industry representatives, and consumers, is to submit recommendations to the General Assembly by October 1, 2003, regarding a redesigning of the Case Management Program for Frail Elders. The new provision also requires DEA and DHS to resolve issues relating to level of care determinations no later than October 1, 2003.
• Amends the provision relating to the State Maximum Allowable Cost Program for Medicaid drug reimbursement to provide that if information required to be provided by pharmacies and providers to DHS under the program can be obtained in an alternative manner, the department may obtain the information in the alternative manner. The amendment also provides that information provided by pharmacies and providers is protected by the Uniform Trade Secrets Act, Code Chapter 550.
• Amends the provision relating to nursing facility reimbursement to provide for quarterly review of projections of reimbursements to determine if an interim adjustment is necessary to remain within the amount specified for reimbursement.
• Amends the provision relating to chronic care management to refer to a chronic care consortium and to provide for the procuring of a sole source contract to manage the individuals involved in the Chronic Care Management Program.
• Provides for up to $2.4 million of federal Temporary Assistance for Needy Families Block Grant funds appropriated for FY 2002-2003 that remain at the close of the fiscal year to be used for additional DHS field operations, full-time equivalent positions, and general administration, with $400,000 being used for coordination of services for families with a history of methamphetamine use and $400,000 being used for general administration. This provision takes effect May 2, 2003.
• Provides that in identifying residents of health care facilities who may be eligible for federal veterans' benefits, the Commission of Veterans Affairs is to work with the Commandant of the Iowa Veterans Home, DHS, and the Department of Inspections and Appeals.

HOUSE FILE 628 - Regulation of Physician Assistant Services (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act provides for changes relating to licensure requirements for physician assistants.

The Act eliminates provisions relating to registration of physician assistants, and also eliminates outdated provisions regarding the adoption of rules related to delegated prescribing by a specified date. The Act directs the Board of Medical Examiners to adopt rules relating to the status of a physician as a supervising physician. The Act also directs the boards of Medical Examiners and Physician Assistant Examiners to adopt rules requiring a physician, or physician assistant, to inform their respective boards of the identity of the physician assistant being supervised, or the supervising physician, and of any change in the status of the supervisory relationship. The rules are to provide that no more than two physician assistants shall be supervised by a supervising physician at one time.

The Act provides for changes to the definitions applicable to physician assistants, including requirements applicable to a physician practicing in a federal facility or under federal authority, and provides for modifications regarding requirements for licensure as a physician assistant consistent with the revised definitions and the elimination of registration as a physician assistant.

The Act provides that a physician assistant may, under specified circumstances when responding to an emergency, render care without supervision, or with such supervision as is available. A supervising physician under such circumstances shall not be required to meet rules relating to supervision by physicians, and the physician or a physician assistant shall not be subject to criminal liability or civil damages unless the acts or omission constitute recklessness.

The Act requires the Board of Physician Assistant Examiners, after consultation with the Board of Medical Examiners, to adopt new rules relating to administration of Code Chapter 148C, Medicine and Surgery, on or before January 1, 2004.

The Act takes effect April 30, 2003.

HOUSE FILE 641 - Public Health Regulation - Miscellaneous Provisions (full text of bill)
BY COMMITTEE ON HUMAN RESOURCES. This Act provides for several changes relating to programs administered by or under the authority of the Iowa Department of Public Health. The Act provides for the addition of varicella, commonly referred to as chickenpox, to the list of required childhood immunizations, and adds advanced registered nurse practitioners and physician assistants as health professionals authorized to sign immunization medical waivers. The Act modifies exemption provisions relating to the practice of nursing to clarify that the performance of nursing services by students who are licensed as registered nurses or practical or vocational nurses in a United States jurisdiction shall not qualify for an exemption from the jurisdiction of the Board of Nursing applicable to unlicensed nursing students. The Act provides additional detail regarding licensee review committees formed to monitor impaired licensees, providing that the committees are established for the purpose of evaluating and monitoring licensees who self-report, or are referred by the Board of Nursing for, an impairment relating to alcohol or drug abuse, dependency, or addiction, or any mental or physical disorder.